体素内不相干运动扩散加权成像定量参数评估胰腺癌的分化程度

发布时间：2018-03-14 17:36

本文选题：胰腺肿瘤　切入点：磁共振成像　出处：《中国医学影像学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的胰腺癌早期诊断缺乏有效的筛查工具,本研究通过对比不同病理级别胰腺癌的体素内不相干运动扩散加权成像(IVIM-DWI)表现,探讨IVIM-DWI定量参数在胰腺癌病理分级评估中的应用价值。资料与方法收集病理证实的胰腺癌患者16例(高-中分化10例,低分化6例),采用3.0T MR扫描仪行胰腺多b值DWI。应用IVIM双指数模型分析多b值DWI测量参数,测量并比较高-中分化胰腺癌和低分化胰腺癌的慢表观扩散系数(ADC_(slow))、快表观扩散系数(ADC_(fast))和灌注分数(f)。结果高-中分化胰腺癌的ADC_(slow)值低于低分化胰腺癌的ADC_(slow)值[(0.546±0.041)×10~(-3) mm~2/s比(0.677±0.120)×10~(-3) mm~2/s,P0.05]。高-中分化胰腺癌的f值高于低分化胰腺癌的f值[(59.3±8.8)%比(41.7±22.4)%,P0.05]。鉴别高-中分化胰腺癌和低分化胰腺癌时,ADC_(slow)的曲线下面积大于f的曲线下面积(0.8500.750)。当ADC_(slow)值≤0.599×10~(-3) mm~2/s,鉴别高-中分化胰腺癌和低分化胰腺癌的敏感度为100.00%,特异度为83.33%。当f值44.7%时,鉴别高-中分化胰腺癌和低分化胰腺癌的敏感度为100.00%,特异度为66.67%。结论 IVIM-DWI定量参数ADC_(slow)值和f值能够鉴别高-中分化胰腺癌和低分化胰腺癌,能够术前预测胰腺癌病理分级。鉴别高-中分化胰腺癌和低分化胰腺癌时,ADC_(slow)值和f值具有较高的诊断效能。
[Abstract]:The purpose of the lack of effective screening tool for pancreatic cancer early diagnosis, this study by comparing the different pathological grades of pancreatic cancer intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI), to explore the application value of IVIM-DWI quantitative parameters in pancreatic cancer pathological grading. 16 patients with pancreatic cancer confirmed by pathology were collected data and methods (high in differentiated 10 cases, poorly differentiated 6 cases), using the 3.0T MR scanner for pancreatic B DWI. application of IVIM double exponential model analysis b value DWI parameters were measured and compared in high differentiated pancreatic carcinoma and poorly differentiated pancreatic cancer slow apparent diffusion coefficient (ADC_ (slow)), fast table apparent diffusion coefficient (ADC_ (fast)) and perfusion fraction (f). The results of high - differentiated pancreatic cancer ADC_ (slow) is lower than that of poorly differentiated pancreatic cancer ADC_ (slow) value [(0.546 + 0.041) * 10~ (-3) mm~2/s (0.677 + 0.120) * 10~ (-3) mm~2/s P0.05]., high - in the differentiation of pancreatic The F value is higher than the poorly differentiated carcinoma of pancreatic cancer F value [(59.3 + 8.8)% than (41.7 + 22.4)%, P0.05]. identification of high - and low differentiation in differentiation of pancreatic cancer pancreatic cancer, ADC_ (slow) area under the curve is greater than the area under the curve of F (0.8500.750). When ADC_ (slow) value is less than 0.599 * 10~ (-3) mm~2/s, the identification of high - differentiated pancreatic carcinoma and poorly differentiated pancreatic cancer sensitivity was 100%, specificity was 83.33%. when the F value is 44.7%, the identification of high - differentiated pancreatic carcinoma and poorly differentiated pancreatic cancer sensitivity of 100% and a specificity of 66.67%. IVIM-DWI quantitative conclusion the parameters of ADC_ (slow) and F values can identify high - differentiated pancreatic carcinoma and poorly differentiated pancreatic cancer, pancreatic cancer can predict the pathological grading before operation. The identification of high - differentiated pancreatic carcinoma and poorly differentiated pancreatic cancer, ADC_ (slow) value and F value had a high diagnostic efficiency.

【作者单位】：第四军医大学西京医院放射科;
【基金】：国家自然科学基金重大国际(地区)合作与交流项目(81220108011);国家自然科学基金青年面上连续项目(81370039)
【分类号】：R445.2;R735.9

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